Denture maintenance

Question 1

List common reasons for poor denture hygiene.

Answer 1

• poor manual dexterity
• inability to self care (eg dementia)
• xerostomia (polypharmacy)
• poor diet
• old dentures (loss of polished surface)
• lack of OH knowledge
• wearing dentures 24/7
• ill fitting dentures
• poor neuromuscular control

Question 2

What are examples of debris that can build up on dentures?

Answer 2

• plaque
• calculus
• food

Question 3

Define the pellicle layer.

Answer 3

• salivary proteins and bacterial products
• create a layer to which oral debris and microorganisms adhere to

Question 4

What makes up oral debris?

Answer 4

• mucin
• food
• desquamated epithelial cells

Question 5

What bacteria are found in the oral biofilm?

Answer 5

• staph aureus
• E. coli
• alpha streptococci
• spirochaetes
• fusobacteria (sulphur products create halitosis)

Question 6

What fungi are found in the oral biofilm?

Answer 6

Candida has an affinity for PMMA, acidic environment under denture favours candidal activity

Question 7

Where does debris accumulate on dentures?

Answer 7

• fit surface as not exposed to saliva and cleaning effects
• soft linings attract bacteria
• xerostomia can exacerbate problems

Question 8

What are the consequences of poor denture hygiene?

Answer 8

• caries
• periodontal disease (enhances but does not cause)
• denture stomatitis
• halitosis
• pain

Question 9

What is aspiration pneumonia?

Answer 9

• denture acts as reservoir for respiratory pathogen
• pneumonia is caused by aspiration of food, reflux and oral bacteria most commonly in older people

Question 10

How are dentures mechanically cleaned?

Answer 10

• soap and soft bristle brush
• microwave for 20s (PMMA dentures)
• ultrasonic

Question 11

Why is mechanical cleaning of dentures important?

Answer 11

• removes obvious debris
• must be mechanically cleaned before chemical cleaning
• give the ability to establish better hygiene
• hygienist cannot clean dentures must be done by dentist

Question 12

What are the ideal properties of a chemical denture cleaner?

Answer 12

• cheap
• easy to use
• effective removal of biofilm
• effective stain removal
• bactericidal and fungicidal
• harmless to denture materials
• non-toxic

Question 13

What are different types of chemical denture cleaners?

Answer 13

• alkaline peroxides
• alkaline hypochlorites
• acids
• enzymes
• abrasive cleaners

Question 14

Describe alkaline peroxide denture cleaner.

Answer 14

• most common
• light-duty denture cleaner
• active ingredient is sodium perborate
• effervescent
• tablet or powder form
• does not effectively remove stains or calculus
• eg steradent

Question 15

Describe alkaline hypochlorite denture cleaner.

Answer 15

• very effective antibacterial and anti fungal cleaning
• may corrode metal elements (10 mins max if metal)
• do not use for soft linings
• eg dentural

Question 16

Describe acid denture cleaner.

Answer 16

• good at dissolving calculus and stains
• citric acid or vinegar
• do not use for soft linings or metal based dentures
• eg. denclen

Question 17

Describe enzyme denture cleaner.

Answer 17

• expensive
• proteolytic enzymes
• dextranase, mutanase and protease
• eg. polident

Question 18

Describe abrasive denture cleaner.

Answer 18

• good for stain removal
• can cause damage to denture
• less effective antimicrobial activity than other cleaners
• adjunctive chemical soak required
• eg dentu-creme

Question 19

What are some drawbacks of using chemical denture cleaners?

Answer 19

• must follow MI
• can cause damage or bleaching
• allergies

Question 20

What effect can acidic cleaners have on metal based dentures?

Answer 20

• tarnishing and corrosion
• galvanic reactions

Question 21

How should metal based dentures be cleaned?

Answer 21

• soak in water overnight
• alkaline peroxide cleaner for 15 mins
• alkaline hypochlorite cleaner for 10 mins

Question 22

How should soft linings be cleaned?

Answer 22

• soak in cold water overnight
• alkaline peroxide for 15 mins
• avoid hard toothbrushes

Question 23

What daily care steps should denture patients take?

Answer 23

• brush dentures daily, soft bristles and no toothpaste
• rinse dentures after each meal
• soak dentures daily following MI
• rinse throughly with water after chemical then soak overnight in water

Question 24

What may cause poor compliance with removing dentures at night?

Answer 24

• dignity
• relationships
• self-esteem
• TMJ issues
• bruxists